Mind Matters -- December 2004Written by Ron Sterling, M.D. and Published in Northwest Prime Time Magazine

The Relaxation Responseby Ron Sterling, M.D. -- December 2004

Dear Dr. Ron:

Sometimes, I wish I had clinical depression instead of anxiety attacks. It seems so difficult to treat anxiety and so much easier to treat depression. Medications for anxiety seem to be addictive or at least very habituating. Do you have any suggestions or recommendations? -- Signed: Wishing for Less Stress.

Dear Wishing:

Thank you for writing! There is some truth to what you say about medications for anxiety. Although they can be very helpful, unlike most antidepressants, they do not appear to furnish our brains or bodies with a biological fix that lasts, so they are vulnerable to being classified as "habituating."

It seems that only in matters of the brain do we have difficulty accepting that a brain deficit may require long-term use of a medication. For a more comprehensive discussion of anxiety medications, please tune in to next month's column. In this column, I will write about non-medication solutions.

Anxiety is much more complex than depression. This is primarily because the "fight-or-flight" response sets off very widespread consequences in our bodies. Most of the symptoms of anxiety disorders are related to the fight-or-flight response -- increased heart rate, sweating, trembling, feeling short of breath, nausea, dizziness, detachment (spacey), chills, hot flashes, flushing, muscle tension, flashbacks, feeling trapped, and numbness.

As you might expect, fight-or-flight responses are very strong and difficult to control because they are the essence of survival. Chemicals like adrenaline, noradrenaline and cortisol are released into our bloodstream. Our respiratory rate increases. Blood is directed away from our digestive tract and into our muscles. Our blood pressure rises. Our muscles tense up and we may tremble. By its very nature, the fight-or-flight system bypasses our rational mind.

When we face very real dangers to our physical survival, the fight-or-flight response is invaluable. However, the fight-or-flight response can be activated by perceived dangers, anticipated dangers, and minimal dangers such as rush-hour traffic or missing a deadline. These modern day "threats" trigger the same responses as if our physical survival was threatened.

To protect ourselves in a world of psychological rather than physical danger, it is wise to take the time to figure out when we are actually over-reacting. It is also wise to take the time to figure out if we are allowing ourselves to experience too many moderate to severe threats from our environment. Once we have identified whether a threat is real and should be minimized in some way, and once we have identified our particular "fear buttons," we can take appropriate action.

Appropriate actions can include changing our external environment or our fear buttons, and developing a general relaxation response and exercising regularly. Physical safety may mean getting out of toxic, noisy or hostile environments. Emotional safety may mean getting better at finding friends who genuinely care for us, or getting out of destructive jobs. Altering fear buttons may mean confronting and dealing with specific phobias, and hurts or traumas from the past that set us up for chronic fearfulness. Developing a general relaxation technique may mean learning to meditate, practice yoga, develop deep breathing or progressive muscle relaxation techniques.

Exercising regularly is just that. However, for the purpose of stress reduction, we do not need to exercise for 30 to 40 minutes every day. Any form of activity where we work up a sweat for five minutes will effectively metabolize and prevent the excessive buildup of stress hormones.

A meditative technique known as the "relaxation response" was described in 1975 by Harvard physician Herbert Benson, M.D. in his book "The Relaxation Response." Since then, the technique has been proven to reduce many of the physical and psychological consequences of anxiety.

The key to deriving the benefits of the relaxation response is to practice it daily. Dr. Benson recommends at least 10 to 15 minutes at day. The technique consists of the repetition of a word, sound, or phrase while sitting quietly with eyes closed. Focus on a word or phrase that has a positive meaning for you. Such words as "love" and "peace" work well. Effective phrases include any phrase the gives you a sense of peace and comfort.

When you find your mind has wandered or you notice any intrusive thoughts, simply disregard them and return your focus to your chosen word or phrase. Dr. Benson says "to summon the healing effects of the relaxation response, you need to surrender everyday worries and tensions." When you realize your mind has wandered, just let go of the intrusive thought and return back to your word or phrase.

Remember, whether your mind wanders or your thoughts drift, simply practicing the relaxation response will elicit the benefits. Don't worry whether you think you had a "good relaxation response" or not. Whether you "felt" your meditation was a calming, relaxing experience or not, you will be gaining benefits.

I hope this is helpful. For more information about the relaxation response, please visit www.MentalWellness.ws. -- Best wishes, Dr. Ron.

Author Bio:

Ron Sterling, M.D. is a 64 year-old General and Geriatric Psychiatrist with a private practice in Seattle. He invites you to e-mail him at with any questions about mental wellness or emotional, relationship, or aging concerns. He is the only person who reads e-mail sent to Dr. Ron. Please be assured that your questions and identities are completely confidential and protected. For more information about Dr. Ron and for resources related to senior mental health, please go to SeniorMentalHealth.org. The content offered through Mind Matters is for information only and is not intended for medical, psychiatric, or psychological diagnosis or treatment. Never disregard professional advice or delay seeking it because of something you have read in this column. Read our Disclaimer. If you wish to understand more about Dr. Sterling's potential biases in health care advocacy, please check his Conflicts of Interest Disclosure Statement